Conclusion

Extensive research over the past 30 years has identified key determinants of VILI. From this, practice has been modified in an attempt to minimise lung damage. In the case of ARDS, ventilation with lower tidal volumes has been shown to reduce mortality.

One of the most exciting developments has been the realisation that VILI may be caused not only by the mechanical disruption of lung tissue, but also by the inappropriate activation of cellular pathways. Such mechanisms may contribute to non-pulmonary organ damage. Future treatments to minimise the impact of VILI may target these mechanisms at the molecular level, in addition to developing less injurious ventilation strategies.

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